Identifying High-Need, High-Cost Patients: A Real-World Perspective
Authors: Lucy A. Savitz, Kelly Rice Williams, Dan Swayze
Journal: Annals of Internal Medicine (2022)

EditorialsDecember 2022Identifying High-Need, High-Cost Patients: A Real-World PerspectiveLucy A. Savitz, PhD, MBA, Kelly Rice Williams, PhD, MPH, Dan Swayze, DrPH, MBA, MEMSLucy A. Savitz, PhD, MBADepartment of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, UPMC Center for High-Value Health Care, and UPMC Health Plan, Pittsburgh, PennsylvaniaSearch for more papers by this author, Kelly Rice Williams, PhD, MPHUPMC Center for High-Value Health Care, Pittsburgh, PennsylvaniaSearch for more papers by this author, Dan Swayze, DrPH, MBA, MEMSUPMC Health Plan, Pittsburgh, PennsylvaniaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-3161 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Drawing on earlier work from the National Academy of Medicine, Berkman and colleagues (1) used a novel technique to update an existing framework for identifying high-need, high-cost (HNHC) patients. Through a systematic and realist review of the peer-reviewed literature, the authors aimed to identify evidence-based characteristics of HNHC patients. We offer a real-world perspective on how the modified framework contributes to identifying member or patient needs, what appears to be missing, and possible next steps.ContributionsDevelopment of a framework that considers both quantitative and qualitative data is an important attribute of Berkman and colleagues' effort. Data integration from mixed-methods ...References1. Berkman ND, Chang E, Seibert J, et al. Characteristics of high-need, high-cost patients. A “best-fit” framework synthesis. Ann Intern Med. 2022;175:1728-41. doi:10.7326/M21-4562 LinkGoogle Scholar2. Savitz LA, Bayliss EA. Emerging models of care for individuals with multiple chronic conditions. Health Serv Res. 2021;56 Suppl 1:980-989. [PMID: 34387358] doi:10.1111/1475-6773.13774 CrossrefMedlineGoogle Scholar3. Joynt KE, Whellan DJ, O’Connor CM. Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry. 2003;54:248-61. [PMID: 12893101] CrossrefMedlineGoogle Scholar4. Horenstein A, Heimberg RG. Anxiety disorders and healthcare utilization: a systematic review. Clin Psychol Rev. 2020;81:101894. [PMID: 32818687] doi:10.1016/j.cpr.2020.101894 CrossrefMedlineGoogle Scholar5. Gandhi SO, Sabik L. Emergency department visit classification using the NYU algorithm. Am J Manag Care. 2014;20:315-20. [PMID: 24884862] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, UPMC Center for High-Value Health Care, and UPMC Health Plan, Pittsburgh, PennsylvaniaUPMC Center for High-Value Health Care, Pittsburgh, PennsylvaniaUPMC Health Plan, Pittsburgh, PennsylvaniaDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3161.Corresponding Author: Lucy A. Savitz, PhD, MBA, Department of Health Policy and Management, School of Public Health, A618 Pitt Public Health, 130 DeSoto Street, Pittsburgh, PA 15261; e-mail, [email protected]edu.This article was published at Annals.org on 8 November 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCharacteristics of High-Need, High-Cost Patients Nancy D. Berkman , Eva Chang , Julie Seibert , and Rania Ali Metrics December 2022Volume 175, Issue 12Page: 1767-1768KeywordsBehaviorHealth care utilizationMedical risk factorsRisk management ePublished: 8 November 2022 Issue Published: December 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...